目的核算2018年上海市预防服务费用,分析公共卫生的投入与补偿模式,提出针对性的对策建议。方法基于卫生费用核算体系2011(System of Health Accounts 2011 Edition,SHA 2011),核算并阐述上海市预防服务费用的基本情况、功能配置、筹资...目的核算2018年上海市预防服务费用,分析公共卫生的投入与补偿模式,提出针对性的对策建议。方法基于卫生费用核算体系2011(System of Health Accounts 2011 Edition,SHA 2011),核算并阐述上海市预防服务费用的基本情况、功能配置、筹资补偿和机构流向。基于样本机构,梳理公共卫生投入及补偿情况。结果上海市预防服务总费用为151.66亿元,占经常性卫生费用的7.61%,人均预防服务费用为625.72元。预防服务费用主要用于其他项目、健康体检、免疫规划和慢性病管理等项目;主要发生在医院、基层医疗卫生机构和公共卫生机构,分别占47.24%、36.60%和16.16%;筹资来源以政府方案、家庭卫生支出和企业筹资方案为主。结论预防服务提供成本难以准确衡量,需从源头把控数据填报质量,加强核算数据精确性。公立医院公共卫生的投入与补偿需进一步明确政府责任,完善机制建设,稳步推进“医防融合”模式转变。展开更多
Health care costs are high and continue to rise in most major economies,and the health savings account(HSA)is often viewed as an appealing way to contain health care costs because it can potentially solve the moral ha...Health care costs are high and continue to rise in most major economies,and the health savings account(HSA)is often viewed as an appealing way to contain health care costs because it can potentially solve the moral hazard spending caused by traditional health insurance.This study uses data from the China Household Finance Survey(CHFS)to empirically examine the effectiveness of HSAs in containing medical expenses and reducing moral hazard.The findings show that HSAs that restrict the use of funds may lead enrollees to discount the value and thus spend more on health care.In addition,the positive effect of HSAs on medical expenses is larger for the relatively healthier group,which may suggest that moral hazard exists regarding the use of HSA funds.The empirical estimates of the HSA effect on medical expenses are robust when a set of covariates are controlled,and HSA balances are instrumented using housing savings account balances.展开更多
文摘目的核算2018年上海市预防服务费用,分析公共卫生的投入与补偿模式,提出针对性的对策建议。方法基于卫生费用核算体系2011(System of Health Accounts 2011 Edition,SHA 2011),核算并阐述上海市预防服务费用的基本情况、功能配置、筹资补偿和机构流向。基于样本机构,梳理公共卫生投入及补偿情况。结果上海市预防服务总费用为151.66亿元,占经常性卫生费用的7.61%,人均预防服务费用为625.72元。预防服务费用主要用于其他项目、健康体检、免疫规划和慢性病管理等项目;主要发生在医院、基层医疗卫生机构和公共卫生机构,分别占47.24%、36.60%和16.16%;筹资来源以政府方案、家庭卫生支出和企业筹资方案为主。结论预防服务提供成本难以准确衡量,需从源头把控数据填报质量,加强核算数据精确性。公立医院公共卫生的投入与补偿需进一步明确政府责任,完善机制建设,稳步推进“医防融合”模式转变。
文摘Health care costs are high and continue to rise in most major economies,and the health savings account(HSA)is often viewed as an appealing way to contain health care costs because it can potentially solve the moral hazard spending caused by traditional health insurance.This study uses data from the China Household Finance Survey(CHFS)to empirically examine the effectiveness of HSAs in containing medical expenses and reducing moral hazard.The findings show that HSAs that restrict the use of funds may lead enrollees to discount the value and thus spend more on health care.In addition,the positive effect of HSAs on medical expenses is larger for the relatively healthier group,which may suggest that moral hazard exists regarding the use of HSA funds.The empirical estimates of the HSA effect on medical expenses are robust when a set of covariates are controlled,and HSA balances are instrumented using housing savings account balances.
